On multivariable analysis, however, the risk of death or MI was higher for both women (OR 1.9, 95% CI 1.2-2.8) and minorities (OR 1.9, 95% CI 1.2-2.8), reported Wayne B. Batchelor, MD, MHS, of Southern Medical Group in Tallahassee, Fla., and Roxana Mehran, MD, of Mount Sinai School of Medicine in New York City.

"Further study into the cause of these trends is warranted," the investigators concluded. "Similar rates of target vessel revascularization and stent thrombosis among all three groups suggest that 'stent failure' is unlikely to account for the observed differences in outcome."

"We've got to do a better job enrolling women and minorities in clinical trials," Batchelor emphasized during a TCT press conference.

He suggested that socioeconomic and behavioral factors may have had a hand in the trends observed, citing examples such as income, education, access to healthcare, medication adherence, and language barriers.

"There may be some biology to this as well," he continued. Some evidence in prior literature have suggested differences in thrombogenicity and platelet reactivity in women and minorities.

The PLATINUM DIVERSITY analysis included an original cohort (n=1,501) "enriched" with the PROMUS ELEMENT PAS observational study group (n=2,687). The PLATINUM DIVERSITY patients got at least one Promus Premier stent and self-identified as female, black, Hispanic, or Native American. Their peers in the latter trial came from an all-comers population and got Promus Element Plus devices.

After pooling, patients were characterized as women (n=1,863), white men (1,635), and minorities (n=1,059); 12-month follow-up was achieved in at least 93% of patients.

Compared with white men, women and minorities were more likely to present with diabetes, hypertension, and renal disease. Lesion length and calcification reached higher degrees in women and minorities as well.

On the other hand, both groups showed lower odds of acute coronary syndrome at baseline and had a lower rate of thrombus than did white men.

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